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A hunger strike is a method of non-violent resistance or pressure in which participants fast as an act of political protest, or to provoke feelings of guilt in others, usually with the objective to achieve a specific goal, such as a policy change. Most hunger strikers will take liquids but not solid food.

In cases where an entity (usually the state) has or is able to obtain custody of the hunger striker (such as a prisoner), the hunger strike is often terminated by the custodial entity through the use of force-feeding.

Fasting was used as a method of protesting injustice in pre-Christian Ireland, where it was known as Troscadh or Cealachan. It was detailed in the contemporary civic codes, and had specific rules by which it could be used. The fast was often carried out on the doorstep of the home of the offender. Scholars speculate this was due to the high importance the culture placed on hospitality. Allowing a person to die at one's doorstep, for a wrong of which one was accused, was considered a great dishonor. Others say that the practice was to fast for one whole night, as there is no evidence of people fasting to death in pre-Christian Ireland. The fasts were primarily undertaken to recover debts or get justice for a perceived wrong. There are legends of St. Patrick, the patron saint of Ireland, using the hunger strike as well.[1]

In India, the practice of a hunger protest, where the protestor fasts at the door of an offending party (typically a debtor) in a public call for justice, was abolished by the government in 1861; this indicates the prevalence of the practice prior to that date, or at least a public awareness of it.[1] This Indian practice is ancient, going back to around 400 to 750 BC. This can be known since it appears in the Ramayana, which was composed around that time. The actual mention appears in the Ayodhya kanda (the second book of the Ramayana), in Sarga (section) 103. Bharata has gone to ask the exiled Rama to come back and rule the kingdom. Bharata tries many arguments, none of which work, at which point he decides to do a hunger strike. He announces his intention to fast, calls for his charioteer Sumantra to bring him some sacred Kusha grass (which Sumantra won't do, since he's too busy looking at Rama's face, so Bharata has to get the grass himself), and lies down upon the grass in front of Rama. Rama, however, is quickly able to persuade him to abandon the attempt. Rama mentions it as a practice of the brahmanas.

In the first 3 days, the body is still using energy from glucose.[citation needed] After that, the liver starts processing body fat, in a process called ketosis. After 3 weeks the body enters a "starvation mode". At this point the body "mines" the muscles and vital organs for energy, and loss of bone marrow becomes life-threatening. There are examples of hunger strikers dying after 52 to 74 days of strike.[2]

Mahatma Gandhi was imprisoned in 1922, 1930, 1933 and 1942. Because of Gandhi's stature around the world, British authorities were loath to allow him to die in their custody. It is likely Britain's reputation would have suffered as a result of such an event. Gandhi engaged in several famous hunger strikes to protest British rule of India. Fasting was a non-violent way of communicating the message and sometimes dramatically achieve the reason for the protest. This was keeping with the rules of Satyagraha.

In addition to Gandhi, various others have used the hunger strike option during the Indian independence movement. Such figures include Jatin Das (who fasted to death) and Bhagat Singh. It was only on the 116th day of their fast, on October 5, 1929 that Bhagat Singh and Dutt gave up their strike (surpassing the 97 day world record for hunger strikes which was set by an Irish revolutionary). During this hunger strike that lasted 116 days and ended with the British succumbing to his wishes, he gained much popularity among the common Indians. Before the strike his popularity was limited mainly to the Punjab region.

After Indian Independence, freedom fighter Potti Sreeramulu used hunger strikes to get a separate state for Telugu-speaking people. Morarji Desai went on fast twice during Nav Nirman in the seventies and prior to that Indulal Yagnik alias Indu Chacha went on a long fast during Maha Gujarat and thereafter in the seventies.

He is revered as Amarajeevi (Immortal being) in Coastal Andra for his sacrifice. As a devout follower of Mahatma Gandhi, he worked for much of his life to uphold principles such as truth, non-violence and patriotism, as well as causes such as Harijan movement to end the traditional alienation of, and accord respect and humane treatment to those traditionally called "untouchables" in Indian society.

In the early 20th century suffragettes frequently endured hunger strikes in British prisons. Marion Dunlop was the first in 1909. She was released, as the authorities did not want her to become a martyr. Other suffragettes in prison also undertook hunger strikes. The prison authorities subjected them to force-feeding, which the suffragettes categorized as a form of torture. Emmeline Pankhurst's sister Mary Clarke died shortly after being force-fed in prison, and others including Lady Constance Bulwer-Lytton are believed to have had serious health problems caused by force feeding.[3]

In 1913 the Prisoner's Temporary Discharge of Ill Health Act (nicknamed the "Cat and Mouse Act") changed policy. Hunger strikes were tolerated but prisoners were released when they became sick. When they had recovered, the suffragettes were taken back to prison to finish their sentences.

Hunger strikes have deep roots in Irish society and in the Irish psyche. Fasting in order to bring attention to an injustice which one felt under his lord, and thus embarrass him into a solution, was a common feature of early Irish society and this tactic was fully incorporated into the Brehon legal system. The tradition is ultimately most likely part of the still older Indo-European tradition of which the Irish were part.[4]

The tactic was used by Irish republicans from 1917 and, subsequently, during the Anglo-Irish War, in the 1920s. Early use of hunger strikes by republicans had been countered by the British with force-feeding, which culminated in 1917 in the death of Thomas Ashe in Mountjoy Prison.

In October 1920, the Lord Mayor of Cork, Terence MacSwiney, died on hunger strike in Brixton prison. Two other Cork IRA men, Joe Murphy and Michael Fitzgerald, also died on hunger strike in this protest. Over a period of 94 days, from August 11 to November 12, 1920 John and Peter Crowley, Thomas Donovan, Michael Burke, Michael O'Reilly, Christopher Upton, John Power, Joseph Kenny and Seán Hennessy, demanding reinstatement of political status and release from prison, undertook a hunger strike at the prison of Cork.[5][6]Arthur Griffith called off the strikes after the deaths of MacSwiney, Murphy and Fitzgerald.

Cloistered below decks in cages which held 50 internees, the prisoners were forced to use broken toilets which overflowed frequently into their communal area. Deprived of tables, the already weakened men ate off the floor, frequently succumbing to disease and illness as a result. There were several hunger strikes, including a major strike involving upwards of 150 men in the winter of 1923.

After the end of the Irish Civil War in October 1923, up to 8000 IRA prisoners went on hunger strike to protest their continued detention by the Irish Free State (a total of over 12,000 republicans had been interned by May 1923). Two men, Denny Barry and Andrew O'Sullivan, died on the strike. The strike, however, was called off before any more deaths occurred. The Free State subsequently released the women republican prisoners. Most of the male Republicans were not released until the following year.

The tactic was revived by the Provisional IRA in the early 1970s, when several republicans such as Sean MacStiofain successfully used hunger strikes to get themselves released from custody without charge in the Republic of Ireland. Michael Gaughan died after being force-fed in a British prison in 1974. Frank Stagg, an IRA member being held in a British jail, died after a 62-day hunger strike in 1976 which he began as a campaign to be repatriated to Ireland.

In 1980, seven Provisional Irish Republican Army (IRA) prisoners in the Maze Prison launched a hunger strike as a protest against the revocation by the UK government of a prisoner-of-war-like Special Category Status for paramilitary prisoners in Northern Ireland. The strike, led by Brendan Hughes, was called off before any deaths, when the Government seemed to offer to concede their demands; however, the Government then reneged on the details of the agreement. The prisoners then called another hunger strike the following year. This time, instead of many prisoners striking at the same time, the hunger strikers started fasting one after the other in order to maximise publicity over the fate of each one.

Bobby Sands was the first of ten republican paramilitary prisoners to die during a hunger strike in 1981. There was widespread sympathy for the hunger strikers from Irish republicans and the broader nationalist community on both sides of the Irish border. Bobby Sands was elected as an MP to the UK's Houses of Parliament and two other hunger strikers, Paddy Agnew and Kieran Doherty, were elected to Dáil Éireann in the Republic of Ireland by electorates who wished to register their opposition to the UK Government's then policy. The ten men survived without food for 46 to 73 days,[7] taking only water and salt, before succumbing. After the deaths of the men and severe public disorder, the Government granted partial concessions to the prisoners, and the strike was called off. The hunger strikes gave a huge propaganda boost to a previously severely demoralised Provisional IRA.

On April 3, 1972, Pedro Luis Boitel, an imprisoned poet and dissident, declared himself on hunger strike. After 53 days on hunger strike, receiving only liquids, he died of starvation on May 25, 1972. His last days were related by his close friend, poet Armando Valladares. He was buried in an unmarked grave in the Cólon Cemetery in Havana.

Jorge Luis García Pérez (known as Antúnez) has done hunger strikes. In 2009, following the end of his 17-year imprisonment, Antúnez, his wife Iris, and Diosiris Santana Pérez started a hunger strike to support other political prisoners. Leaders from Uruguay, Costa Rica, and Argentina declared their support for Antúnez.[10][11]

On February 23, 2010, Orlando Zapata Tamayo, a dissident arrested in 2003 as part of a crackdown on opposition groups, died in a hospital while undertaking a hunger strike that had been ongoing for 83 days, in Cuba's "Kilo 8" prison. He had declared the hunger strike in protest of the poor conditions of the prison in which he was held.[12] He was one of 55 prisoners of conscience in Cuba to have been adopted by Amnesty International. He was charged with an array of offences, including "resistance", "contempt", and "disrespect".

Article 6 of the 1975 World Medical AssociationDeclaration of Tokyo states that doctors are not allowed to forcefeed hungerstrikers. They are supposed to understand the prisoner's independent wishes, and it is recommended to have a second opinion as to the capability of the prisoner to understand the implication of his decision and be capable of informed consent.

Where a prisoner refuses nourishment and is considered by the physician as capable of forming an unimpaired and rational judgment concerning the consequences of such a voluntary refusal of nourishment, he or she shall not be fed artificially. The decision as to the capacity of the prisoner to form such a judgment should be confirmed by at least one other independent physician. The consequences of the refusal of nourishment shall be explained by the physician to the prisoner.

The American Medical Association (AMA) is a member of the WMA, but the AMA's members are not bound by the WMA's decisions, as neither organization has formal legal powers. The AMA has formally endorsed the WMA Declaration of Tokyo and has written several letters to the US Government and made public statements in opposition to US physician involvement in force feeding of hunger strikers in contravention of medical ethics.[13] The United StatesCode of Federal Regulations rule on hunger strikes by prisoners states, "It is the responsibility of the Bureau of Prisons to monitor the health and welfare of individual inmates, and to ensure that procedures are pursued to preserve life." It further provides that when "a medical necessity for immediate treatment of a life or health threatening situation exists, the physician may order that treatment be administered without the consent of the inmate."[14]